Ticks and Lyme Disease

What is Lyme disease?

Lyme disease is an infection caused
by the bacteria Borrelia burgdorferi. This spiral shaped bacterium is most commonly
spread by a tick bite. The disease takes its name from Lyme, CT. This is where the
illness was first identified in the U.S. in 1975.

Lyme disease is a year-round
problem. But April through October is generally the most active tick season. Cases of
Lyme disease have been reported in nearly all states in the U.S. and in large areas in
Europe and Asia. But the most common areas are the Northeast, upper Midwest, and
northwestern states.

What causes Lyme disease?

Lyme disease is caused by bacteria
that is spread to humans by tick bites. The ticks that carry the bacteria are:

Ticks prefer to live in wooded
areas, low-growing grasslands, and yards. Not all ticks carry the Lyme disease bacteria.
Depending on the location, anywhere from less than 1 in 100 to more than half of the
ticks are infected with it.

While most tick bites are harmless, several species can cause life-threatening diseases. Tick-borne diseases include:

Rocky Mountain spotted fever

Lyme disease

Anaplasmosis

Babesiosis

Colorado tick fever

Powassan encephalitis

Tularemia

Ehrlichiosis

Relapsing fever

Who is at risk for Lyme disease?

Factors that can increase your risk for getting Lyme disease include:

Working or spending time outdoors in
grassy areas where the black-legged deer tick or Western black-legged deer tick is
found

Having pets that can bring the ticks into the home

What are the symptoms of Lyme disease?

Many people infected with the Lyme
bacteria will never have symptoms. Their bodies will cure the infection without needing
any treatment. If the infection causes symptoms, the following are the most common ones
that people have. They vary based on how long the person has had the infection.

The primary symptom is a red rash that:

Can appear several days after infection, or not at all

Can last up to several weeks

Can be very small or grow very large (up to 12 inches across), and may resemble a "bulls-eye"

Several days or weeks after a bite
from an infected tick, you may get the rash again. When the rash returns, it often
affects many parts of the body. You may also have flu-like symptoms, such as:

Headache

Stiff neck

Aches and pains in muscles and joints

Low-grade fever and chills

Tiredness (fatigue)

Poor appetite

Swollen glands

Weeks to months after the bite, you
may develop:

Nervous system symptoms, including
inflammation (meningitis) and weakness and paralysis of a facial nerve (Bell
palsy)

Heart problems, including inflammation of the heart (myopericarditis) and problems with heart rate

Eye problems, including inflammation (for example, red eye)

Months to a few years after a bite,
you may have:

Inflammation of the joints (arthritis)

Nervous system symptoms, such as
numbness in the arms or legs, tingling and pain, and trouble with speech, memory, and
concentration

.

How is Lyme disease diagnosed?

Sometimes diagnosing Lyme disease
can be hard. The symptoms may seem like other health problems. It may also not be known
if the person was exposed to ticks.

Diagnosis is usually based on
symptoms, particularly the typical rash of Lyme disease, along with a history of a known
or possible tick bite. At the time of the first rash, testing is still negative and not
helpful. For later symptoms, blood testing may be done to confirm the diagnosis and rule
out other conditions.

The symptoms of Lyme disease may
look like other health problems. And other problems can be mistakenly diagnosed as Lyme
disease. Always talk with your healthcare provider for a proper diagnosis.

How is Lyme disease treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on
how severe the condition is.

Lyme disease in the earliest
stage is treated with antibiotics for 2 to 3 weeks. Later stages may require up to 8
weeks of antibiotics, rarely more. Doxycycline is the most common antibiotic used. In
some cases, amoxicillin, cefuroxime, and ceftriaxone may be used.

Treatment will also be considered
based on these and other factors:

If you are bitten by a tick and have
any of the symptoms

If you are bitten by a tick and are
pregnant

If you are bitten by a tick and live
in a high-risk area

What kind of tick you are bitten by

If the tick has taken a blood meal (engorged)

How long the tick has likely been on your body

What are possible complications of Lyme disease?

Lyme disease affects people
differently. Many people with Lyme disease are diagnosed early and cured by their first
treatment. Relapse and incomplete treatment are unusual. You are more likely to become
reinfected after proper treatment if you are bitten by another tick.

Even untreated, most people with
the disease will never develop complications. These may include:

Joint infection, usually involving a
single large joint such as the knee

Nervous system disease, including
meningitis and encephalitis

Heart inflammation (myocarditis)

Rarely these complications can
result in chronic, debilitating conditions.

Some people may develop post-Lyme
disease syndrome (PLDS). It may cause lasting musculoskeletal and peripheral nerve
pain, fatigue, and memory problems. But there is no active infection in those with PLDS.
Taking more rounds of antibiotics doesn't help.

Can Lyme disease be prevented?

People aren't able to become immune
to Lyme disease. So even if you've had Lyme disease, you can get it again. No vaccine is
available currently to prevent the disease in humans.

To help prevent Lyme disease, follow these guidelines.

Clothing

Dress appropriately to prevent
and identify tick bites by wearing:

Light-colored clothing

Long-sleeved shirts

Socks and closed-toe shoes

Long pants with legs tucked into socks

Checking for ticks

Look for ticks often on:

All joints: behind the knees,
between fingers and toes, and on underarms

Other areas where ticks are
commonly found: belly button, neck, hairline, top of the head, and in and behind
the ears

Areas of pressure points, including
anywhere that clothing presses tightly on the skin

If you find a tick:

Don't touch the tick with your bare
hand.

Use a pair of tweezers to remove
the tick. Grab the tick firmly by its mouth or head as close to your skin as
possible.

Pull up slowly and steadily without
twisting until it lets go. Don't squeeze the tick, and don't use petroleum jelly,
solvents, knives, or a lit match to kill the tick.

Save the tick. Place it in a
plastic container or bag so it can be tested for disease, if needed.

Wash the bite area well with soap
and water and put an antiseptic lotion or cream on the site.

Call your healthcare provider to
find out about follow-up care. If the tick is discovered within the first 72 hours
after the tick bite, a single dose of doxycycline may be prescribed to help
prevent Lyme disease.

Most experts don't recommend that the tick be tested for the
Lyme bacteria. If negative, this testing is not always accurate. If testing is
positive for the germ, it doesn't mean you were infected.

Insect repellents

Strongly consider using
repellents. Remember to use all repellents safely.

Use a product with DEET to repel
ticks.

Products that have permethrin can
be sprayed only on clothing, not on your skin.

Other measures

These other methods may also help:

Shower after all outdoor activities
are over for the day. This may wash away ticks before they become fully attached
to your skin.

Check pets and children for ticks.

When should I call my healthcare provider?

If your symptoms get worse or you have new symptoms, let your healthcare provider know.

Key points about Lyme disease

Lyme disease is an infection caused by
a bacteria called Borrelia burgdorferi.

Many people infected with the Lyme
bacteria will never have symptoms.

Lyme disease usually starts with a
rash that is often described as a "bulls-eye."

Lyme disease is generally easy to
diagnose, based on symptoms and a history of a tick bite or exposure. Blood tests may
also be used.

Lyme disease in the earliest stage is
usually treated with antibiotics for 2 to 3 weeks. Some people develop complications
if the infection is not found early.

People aren't able to become immune to
Lyme disease. You can get it again if you get another tick bite.

Preventing tick bites is the best
prevention for Lyme disease. If a tick is found on your body in the first 72 hours,
your healthcare provider may give you a preventive antibiotic.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

Know the reason for your visit and what you want to happen.

Before your visit, write down questions you want answered.

Bring someone with you to help you ask questions and remember what your provider tells you.

At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

Ask if your condition can be treated in other ways.

Know why a test or procedure is recommended and what the results could mean.

Know what to expect if you do not take the medicine or have the test or procedure.

If you have a follow-up appointment, write down the date, time, and purpose for that visit.